Chief Psychiatrist - Behavioral Health Medical Director - Remote Eligible

Chief Psychiatrist

The Chief Psychiatrist oversees our behavioral health (BH) clinical program for our Illinois FIDE members. The individual in this role collaborates closely with Clinical Services and the Chief Medical Officer (CMO) to integrate the day-to-day administration and strategic management of behavioral and physical health services, including Utilization Management (UM), Quality Improvement, and value-based payment programs. The Chief Psychiatrist will be based in Illinois and will also lead the development of new products and services in Humana's Medicaid BH delivery model.

Position Responsibilities:

• Leads clinical and quality management components of Humana's BH services
• Oversees, monitors, and assists with the management of psychopharmacology pharmacy benefits manager (PBM) activities, including the establishment of prior authorization, clinical appropriateness of use; consultations and clinical guidance for contracted primary care Providers (PCPs) treating behavioral health‐related concerns not requiring referral to behavioral health specialists
• Develops comprehensive care programs for the management of adult behavioral health concerns typically treated by PCPs, such as ADHD and depression
• Develops targeted education and training for contracted PCPs to screen for mental health and substance use disorders (SUD) using evidence‐based tools (e.g., AUDIT‐C, PHQ‐9 and GAD‐7), performs diagnostic assessments, provide counseling and prescribe pharmacotherapy when indicated, and build collaborative care models in their practices
• Coordinates with the Medical Director to integrate the administration and management of behavioral and physical health services
• Oversees, monitors, and assists with effective implementation of the Quality Management (QM) program; and work closely with the Utilization Management (UM) of services and associated appeals related to adults with mental illness and/or SUD
• Leads BH policy development in Illinois, driving implementation, oversight, and accountability for both Humana internal and external stakeholders including but not limited to the Department Healthcare and Family Services (HFS), Department of Human Services (DHS), and the Department of Public Health (IDPH)
• Adheres to and complies with federal and state laws and programmatic requirements
• Collaborates with Provider relations personnel to ensure high-quality and appropriate care delivered through the BH Provider network
• Establishes and maintains relationships with Providers, advocates, and other key Illinois stakeholders by maintaining open and ongoing communications; represents Humana at public forums and engagement opportunities
• Maintains compliance with BH-related Contract requirements and attends oversight committee meetings to ensure appropriate procedures are adhered to within Humana and within care delivery
• Collaborates closely with corporate and local population health teams in developing programs and strategies to address BH needs at a population health level

Required Qualifications:

• Physician with a current, unencumbered Illinois-license board-certified in psychiatry- Psychiatrist
• Must reside and perform work in the state of Illinois and report to the Market office as needed for training/meetings
• 5+ years clinical experience working in behavioral health
• Knowledge of the managed care industry
• Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, UM, discharge planning and/or home health or rehab

Preferred Qualifications:

• Familiarity with Illinois -based BH organizations
• Medicaid Managed Care clinical or behavioral health leadership experience

Work at Home Requirements:

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Social Security Task:

Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours: 40

Pay Range: The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits:

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer:

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.